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High Metabolic Age and Excessive Adipose Tissue as a Storage Location for Toxins, and their Influence on the Excretory Function of a Liver and Bile Ducts in Patients with a Transplanted Allogenic Kidney

Kaziuk, Magdalena Barbara1; Kosiba, Waldemar2; Kuzniewski, Marek1

doi: 10.1097/

1Jagiellonian University Medical College, Chair and Department of Nephrology, Krakow, Poland; 22nd Internal Branch with Intensive Cardiology Care, Zeromski Hospital, Krakow, Poland.

Introduction: Metabolic age reflects person’s physical health, and is calculated on a basis of the base metabolic rate (BMR). When person’s metabolic age is lower than their actual age, this implies their body is in a good health, while a metabolic age higher than the actual age indicates that the subject may experience some health problems. Adipose tissue is a typical location for storage of water-insoluble toxins in the body. It is a connective tissue, in which the intercellular substance consist of fat. According to the fat distribution in the body, we distinquish two types of obesity: android (abdominal) and gynoidal (peripheral).

Aim: An attempt was made to evaluate an influence of adipose tissue and metabolic age on functions of a transplanted kidney and on an excretory function of a liver and bile ducts.

Material and methods: the study covered 152 patients with the functioning kidney transplant after more than 3 months from the Ktx, 81 women and 71 men. The average patient age was 47.8 ± 11.6 years. Their body composition was assessed using the bioimpendance method (BIA) and anthropometric measurements. Basic metabolic rate (BMR), muscle tissue weight, total body water content, and amount of the adipose tissue, all contributing to the metabolic age, were evaluated. The nutritional status and the obesity type were determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). The excretory function of the transplanted kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using the MDRD formula. Functions of a liver and bile ducts were evaluated as total serum bilirubin levels, and alanine transaminase (ALT) and gamma-glutamyltransferase (GGTP) levels. Haemolitic uremic syndrome (HUS) was excluded in the studied persons.

Results: 51% of patients were diagnosed with obesity. People with an android body type had lower eGFR versus people with the gynoid body type (p < 0.001). The higher the percentage content of the adipose tissue and the metabolic age, the lower was eGFR in the subjects (p < 0,001). The increased ALT, GGTP levels were positively correlated with high content of adipose tissue and high metabolic age (p < 0.05).

Conclusions: Excessive adipose tissue, particularly android obesity, may be a predictor for renal, hepatic and bile ducts injury; therefore, correct diet and pharmacological management, together with physical activity adapted to the physical fitness level of a patient are necessary.

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